The best and worst of the World Cancer Day news

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By Judith Potts

World Cancer Day fell on February 4, and it carried with it the usual glut of stories and updates. It can be hard to keep up – so I’ve collated some of those that stood out.

Let’s start with some good news.  One of the positives for those with HER2-positive metastatic breast cancer is that the drug Perjeta (taken with Herceptin and Docetaxel) has been recommended for routine NHS use in England. This will offer these women an extra 16 months of life.

Another positive is that Hope for Tomorrow, the charity that brings chemotherapy closer to patients’ homes via its mobile cancer care units, has a new reserve unit. Should one of the regular 10 units run into a mechanical problem, or need servicing, ‘Jennifer’ can be deployed so that no patient will miss out on a single chemotherapy appointment.

Meanwhile, Cancer Research UK announced a major study on the anti-cancer properties of aspirin. Before it can be used more widely, there needs to be a way to identify those at risk from the side-effects of strokes, bleeding and stomach ulcers. Professor Jack Cuzick, who is from Queen Mary University, London and is CRUK’s epidemiology expert, is leading an international collaboration of experts on the topic. They will look at who will benefit most from the drug, what is the best dose to take, for how long it should be taken and how aspirin actually works to reduce cancer risk. There is strong evidence that it reduces the risk of bowel cancer and some evidence that it cuts the risk of stomach and oesophageal cancers.

Cancer | The tests you need to know about

For bile duct cancer

Helen Moremont, of the charity AMMF, says if you have symptoms of bile duct cancer that don’t improve, ask your GP to run a liver-function test.

For ovarian cancer

An early ovarian cancer-screening tool is in development. ‘In the meantime, if you have symptoms for longer than a 12-day period, ask your GP for a CA125 blood test,’ says Katherine Taylor of Ovarian Cancer Action. ‘It’s a bio-marker test that’s freely available.’

For cervical cancer

Since the early 1990s, cervical cancer incidence rates have decreased by almost a quarter (23 per cent) in the UK. Women aged 25 to 49 are invited for screening every three years; 50 to 64-year-olds are invited every five years. If you experience bleeding between periods, after sex or following the menopause, or have pain during sex or in your pelvis, see your GP.

For bowel cancer

If bowel cancer is detected early, before symptoms appear, it is easier to treat. The NHS offers two types of bowel-cancer screening. Currently, everybody aged 60 to 74 is sent a home- test kit. There is also a one-off test called bowel scope screening (which takes place at NHS bowel-cancer screening centres), which is gradually being introduced in England for those 55 and over.

And finally…

Don’t forget the protective basics: ‘Four in 10 cases of cancer can be prevented. So if you’re a smoker, stop; keep a healthy weight; eat well and stay active,’ says Dr Jasmine Just of Cancer Research UK. ‘Help stack the odds in your favour.’

Early research by the University of Dundee (published in 2014 in the British Journal of Cancer) concluded that aspirin used post-diagnosis of breast cancer may reduce all-cause and breast cancer-specific mortality. In 2017, researchers from the City of Hope in Duarte, California, found that women who took low-dose aspirin at least three times a week had a 20% lower risk of developing HER2-negative breast cancer.

“We thought that if aspirin can inhibit aromatase, it would reduce the likelihood that breast cancer would develop and it could also be an effective way to improve breast cancer patients’ prognosis once they no longer take the more potent aromatase inhibitors. Aspirin also reduces inflammation, which may be another mechanism by which aspirin taken regularly can lower risk of breast cancer developing or recurring.”

According to Cancer Research UK, “some studies have estimated a low dose aspirin could lead to a 10 per cent drop in the number of people dying from some cancers, but for every 17 lives saved by preventing cancer or heart attacks, there would be 2 deaths from side-effects.” Given the possibility of side effects, readers should consult their GP before self-prescribing.

Away from aspirin, confirmation came from Macmillan Cancer Support that it is now two years since the UK met its cancer waiting times target – 62 days after an urgent GP referral. In 2017, over 25,000 people waited more than two months for treatment to begin and this includes 10,000 who waited more than three months.

Worse, the UK survival rates for all cancers still lag behind the rest of the world. If the UK matched the European average, 10,000 deaths could be prevented each year. Some of these would be from breast cancer, with figures from The Lancet showing that the numbers of women attending for mammograms is at the lowest level for 10 years. Of the 2.59 million invited, only 1.84 million came for screening.

Given the incredibly high profile of breast cancer and the very serious work done by the breast cancer charities, why are so many invitations to mammograms are being refused? Is it because of appointment time difficulties? Are people in denial about breast cancer? Are women really concerned about the procedure itself; is it the tiny amount of radiation involved? Or is it the stories about over-diagnosis and unnecessary surgery?

So much research is being done, yet there are still basic questions that need answering before the UK can rise up through the survival tables.

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